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Positive Dose–Response Relationship Between Urinary Trihalomethanes and Blood Pressure in Adults in Wuxi, China

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Abstract

Trihalomethanes (THMs) are the most common and diverse disinfection byproducts in drinking water. Long-term exposure to THMs may result in cancer and severe reproductive and developmental problems. However, few studies have evaluated the potential effects of THMs on the cardiovascular system. Blood pressure (BP) parameters (including systolic BP, diastolic BP, pulse pressure (PP)), lipid parameters (including total cholesterol and triglycerides), and urinary THM concentrations (trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and tribromomethane (TBM)) were measured in 182 adults at a medical examination center in Wuxi, China. Logistic and linear regression were used to analyze the relationship between urinary THM levels and BP parameters. DBCM, brominated THM (Br-THM), and total trihalomethanes (TTHMs) positively correlated with PP (P < 0.05). Logistic regression models showed significant trends (P < 0.05) towards increasing odds ratios for PP with increasing urinary THMs. The linear regression model also showed that DBCM and Br-THM were significantly positively correlated with PP (P < 0.05) after adjusting for confounding factors. The results of this study suggest that THM exposure influences BP in adults. However, more prospective and experimental studies are needed in the future to validate our findings.

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Data Availability

Data will be made available on request.

Abbreviations

THMs:

Trihalomethanes

BP:

Blood pressure

PP:

Pulse pressure

TCM:

Trichloromethane

BDCM:

Bromodichloromethane

DBCM:

Dibromochloromethane

TBM:

Tribromomethane

TCAA:

Trichloroacetic acid

TCHO:

Total cholesterol

TG:

Triglycerides

BMI:

Body mass index

Br-THM:

Brominated THM

TTHMs:

Total trihalomethanes

OR:

Odds ratio

LOD:

Limit of detection

Cr:

Creatinine

WQS:

Weighted quantiles sum regression

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Acknowledgments

We thank all of the participants for providing urine and serum samples, as well as those who provided technical and funding assistance.

Funding

This study was supported by the Medical Key Discipline Program of Wuxi Health Commission (grant number LCZX2021006), the Scientific Research Project of Wuxi Health Commission (grant number Q202165), the Cohort and Clinical Research Program of Wuxi Medical Center, Nanjing Medical University (WMCC202318) and the Major Program of Wuxi Medical Center, Nanjing Medical University (WMCJ202302).

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Author notes

  1. Shunan Wang and Qianqian Wang have contributed equally to this work.

Authors and Affiliations

  1. Wuxi Center for Disease Control and Prevention, Wuxi Medical Center, the Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Nanjing Medical University, Wuxi, 214023, China

    Shunan Wang, Qianqian Wang, Chao Yang, Li Yang, Lingling Xu, Run Zhou, Limei Chen, Yao Li, Pengfei Zhu & Xinliang Ding

  2. Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China

    Shunan Wang & Xinliang Ding

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  1. Shunan Wang
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Contributions

Shunan Wang and Qianqian Wang contributed equally to this study and should be regarded as joint first authors. Shunan Wang and Qianqian Wang wrote the first draft of the manuscript. Shunan Wang and Li Yang designed the study and analyzed the data. Chao Yang, Yamei Hao, and Lingling Xu collected the questionnaires. Run Zhou, Limei Chen, Yao Li, and Pengfei Zhu performed method validation and supervision. Xinliang Ding was responsible for writing–review, project management and funding acquisition.

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Correspondence to Xinliang Ding.

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Ethical Approval

This study was approved by the Ethics Committee of Wuxi Center for Disease Control and Prevention.

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Wang, S., Wang, Q., Yang, C. et al. Positive Dose–Response Relationship Between Urinary Trihalomethanes and Blood Pressure in Adults in Wuxi, China. Expo Health 17, 765–774 (2025). https://doi.org/10.1007/s12403-025-00692-6

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